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How to Distinguish Medicare from Medicaid

Jan 23 2016

Written by Jason C. Henbest, Esq. and Brittany Saxton

Medicare and Medicaid are well known terms in American health care.  However, they are often confused or deemed synonymous with each other. While both Medicare and Medicaid deal with health care, they provide two different services.  As potential recipients of either service, or as someone simply looking to become more informed, this article provides a brief synopsis of Medicare, Medicaid, and their involvement in the law. 

Medicare is a nationwide social insurance program that uses private insurance companies to provide health insurance to Americans 65+ who have worked and paid into the system. This federal program also provides some health insurance to people who are younger than 65 and disabled. Medicare was part of President Johnson’s agenda during the Great Society in the mid-1960s. The Social Security Act was modified to include Medicare, which is divided into 4 parts: A, B, C and D. Part A of Medicare covers hospital visitation, including the food, room, and tests. Part B covers outpatient care, including visits to doctors and medical equipment—basically health care services and equipment not covered under Part A. Part C falls into the Medicare Advantage plans, a supplement that ensures private companies provide health plans to recipients. Finally, Part D covers prescription drugs plans, allowing anyone eligible for Part A or B to be covered under Part D.  Parts C and D are subject to a separate, privately paid fee. 

Medicaid is a social health care program, both state and federal, for families and persons with limited income and resources. Medicaid provides medical and social services, typically a nurse, assistant, or aide, which allow persons in need of care to remain in their home as long as possible. Medicaid recipients must be U.S. citizens or legal permanent residents. Recipients may include limited-means adults, their children, and those with disabilities. This service often helps pay for residents of nursing homes.

These services, both Medicare and Medicaid, play major roles in elder law and even estate administration. Consider an example of the latter, where creditors may seek payment for medical bills for the decedent of an estate that may already be covered by Medicare. To learn more about these services and the role they play in the law, contact a well-informed attorney, today.